ABSTRACT #8

INSTITUTING AN EVIDENCE-BASED CURRICULUM ON THE EVALUATION OF COMMON GYNECOLOGICAL COMPLAINTS IN THE EMERGENCY DEPARTMENT

Xiteng Yan, Cheryl Dinglas, Robert Dean

PURPOSE AND GOALS: In a recent residency-wide survey, junior residents at Mount Sinai South Nassau reported a lack of readiness in evaluating gynecological consults and noted the lack of formal didactics to prepare them. A pilot education program was created to address these needs.

METHODS: First, we asked our institution’s Health Information Services for the most common gynecological diagnoses in the emergency department. With that information, a series of ten education sessions was created. The topics included, but are not limited to, first trimester bleeding, acute pelvic pain (e.g., ovarian torsion, hemorrhagic cysts, pelvic inflammatory disease, etc.), and abnormal uterine bleeding in pre- and postmenopausal patients.

Participants include a faculty attending, a senior resident, and the junior residents. The sessions incorporate a “Flipped Classroom” model of active learning, with pre-reading assigned the week prior. A didactic review starts each session, which is then followed by a simulated case in which the senior resident acts as the patient and the junior residents act as the providers. The junior residents are required to interview, assess, and devise a management plan.

Continuous review of the topic is facilitated by use of JAMBOARD, a digital interactive whiteboard developed by Google in which participants can ask and answer questions as the case progresses. The purpose of the JAMBOARD is to create a safe space as the posts are anonymous. The posts are discussed as they appear, allowing for reinforcement of the material.

EVALUATION PLAN: Each session is followed by an anonymous survey, which asks whether the prereading, lecture, and simulated case were well-organized, informative, and clinically useful on a scale of 1 to 5, with 1 being “strongly disagree” and 5 being “strongly agree.” Free text is available to detail what aspects of the session worked well and what could be improved. A survey regarding the efficacy of the curriculum in promoting competencies will be performed at the end of the academic year

SUMMARY OF RESULTS: A total of 6 sessions have occurred so far, and a total of 23 surveys have been collected. The average score as to whether the pre-reading, lecture, and case were informative and useful was 4.9/5. Praise include that the sessions were, “interactive and fun […] helpful for practical day to day,” that the “step-by-step approach in walking through a case together, [sic] helps with the thought process,” and that the “Jam board [sic] allows you to explore ideas without fear of embarrassment.”

REFLECTIVE CRITIQUE: The overall response has been positive and affirmed that these sessions allow residents to practice clinical reasoning in a safe space. More research should be performed to determine how the learners’ experiences within the sessions transfer over to clinical settings